中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2012年
44期
8186-8190
,共5页
尹俊萍%苗海敏%乔国勇%伊艳丽
尹俊萍%苗海敏%喬國勇%伊豔麗
윤준평%묘해민%교국용%이염려
膝关节置换%单膝置换%骨水泥%止血带%凝血功能%高凝状态%充填%并发症%纤维蛋白原%组织工程
膝關節置換%單膝置換%骨水泥%止血帶%凝血功能%高凝狀態%充填%併髮癥%纖維蛋白原%組織工程
슬관절치환%단슬치환%골수니%지혈대%응혈공능%고응상태%충전%병발증%섬유단백원%조직공정
背景:有研究表明膝关节置换中骨水泥固定假体时骨水泥对患者的血液动力学及凝血功能的影响较大.目的:观察膝关节置换中骨水泥和止血带对患者凝血功能的影响.方法:采用随机对照研究方法,将骨性关节行单侧膝关节置换患者40例随机分成2组,置换时分别应用止血带和不用止血带.通过比较两组患者血浆凝血酶原时间、活化的部分凝血活酶时间、凝血酶时间、纤维蛋白原及血浆 D-二聚体水平的变化,来观察膝关节置换中骨水泥和止血带对置换中凝血功能的影响.结果与结论:两组患者在骨水泥置入后60,120 min,血浆凝血酶原时间值缩短(P<0.05),纤维蛋白原和D-二聚体在注入骨水泥后增多(P <0.05),其中止血带组的变化更为明显,两组患者在180 min时基本恢复正常,活化的部分凝血活酶时间及凝血酶时间在骨水泥注入前后均无明显变化,另外,所监测的凝血功能相关指标(血浆凝血酶原时间、活化部分凝血酶原时间、凝血酶时间、纤维蛋白原及 D-二聚体的数值在注入骨水泥前后均在正常范围内.相比非止血带组,止血带组血浆凝血酶原时间缩短、纤维蛋白原及D-二聚体含量增多(P<0.05).说明膝关节置换中骨水泥应用后可以使单侧膝关节置换患者的凝血功能处于高凝状态,止血带可加重患者的高凝状态.
揹景:有研究錶明膝關節置換中骨水泥固定假體時骨水泥對患者的血液動力學及凝血功能的影響較大.目的:觀察膝關節置換中骨水泥和止血帶對患者凝血功能的影響.方法:採用隨機對照研究方法,將骨性關節行單側膝關節置換患者40例隨機分成2組,置換時分彆應用止血帶和不用止血帶.通過比較兩組患者血漿凝血酶原時間、活化的部分凝血活酶時間、凝血酶時間、纖維蛋白原及血漿 D-二聚體水平的變化,來觀察膝關節置換中骨水泥和止血帶對置換中凝血功能的影響.結果與結論:兩組患者在骨水泥置入後60,120 min,血漿凝血酶原時間值縮短(P<0.05),纖維蛋白原和D-二聚體在註入骨水泥後增多(P <0.05),其中止血帶組的變化更為明顯,兩組患者在180 min時基本恢複正常,活化的部分凝血活酶時間及凝血酶時間在骨水泥註入前後均無明顯變化,另外,所鑑測的凝血功能相關指標(血漿凝血酶原時間、活化部分凝血酶原時間、凝血酶時間、纖維蛋白原及 D-二聚體的數值在註入骨水泥前後均在正常範圍內.相比非止血帶組,止血帶組血漿凝血酶原時間縮短、纖維蛋白原及D-二聚體含量增多(P<0.05).說明膝關節置換中骨水泥應用後可以使單側膝關節置換患者的凝血功能處于高凝狀態,止血帶可加重患者的高凝狀態.
배경:유연구표명슬관절치환중골수니고정가체시골수니대환자적혈액동역학급응혈공능적영향교대.목적:관찰슬관절치환중골수니화지혈대대환자응혈공능적영향.방법:채용수궤대조연구방법,장골성관절행단측슬관절치환환자40례수궤분성2조,치환시분별응용지혈대화불용지혈대.통과비교량조환자혈장응혈매원시간、활화적부분응혈활매시간、응혈매시간、섬유단백원급혈장 D-이취체수평적변화,래관찰슬관절치환중골수니화지혈대대치환중응혈공능적영향.결과여결론:량조환자재골수니치입후60,120 min,혈장응혈매원시간치축단(P<0.05),섬유단백원화D-이취체재주입골수니후증다(P <0.05),기중지혈대조적변화경위명현,량조환자재180 min시기본회복정상,활화적부분응혈활매시간급응혈매시간재골수니주입전후균무명현변화,령외,소감측적응혈공능상관지표(혈장응혈매원시간、활화부분응혈매원시간、응혈매시간、섬유단백원급 D-이취체적수치재주입골수니전후균재정상범위내.상비비지혈대조,지혈대조혈장응혈매원시간축단、섬유단백원급D-이취체함량증다(P<0.05).설명슬관절치환중골수니응용후가이사단측슬관절치환환자적응혈공능처우고응상태,지혈대가가중환자적고응상태.
BACKGROUND:Studies have shown that bone cement has a great effect on the patient's hemodynamic and blood coagulation during total knee arthroplasty. OBJECTIVE:To observe the effects of bone cement and tourniquet on coagulation function during total knee arthroplasty. METHODS:Forty osteoarthritis patients who underwent single total knee arthroplasty were randomly divided into two groups with randomized control study method:the application of tourniquet and patients who did not have tourniquet. The relative parameters were observed in al patients, including prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dipolymer. Coagulation function changes between two groups were compared. RESULTS AND CONCLUSION:The prothrombin time was significantly decreased at 60 and 120 minutes after cement implantation (P<0.05), and the levels of fibrinogen and D-dipolymer were increased after implantation in al patients (P<0.05), especial y in the patients who use of tourniquet. The changes vanished at 180 minutes after bone cement implantation. There was no significant difference in activated partial thromboplastin time and prothrombin time before and after bone cement implantation. The values of prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dipolymer were within the normal range. Compared with the patients who did not have tourniquet, the prothrombin time in the patients with tourniquet was shortened and the fibrinogen and D-dipolymer were increased (P<0.05). The bone cement implantation can lead to temporal hypercoagulabale state during single total knee arthroplasty, and the tourniquet can aggravate the hypercoagulable state in patients.
